ROY JONES JR. VS BERNARD HOPKINS 2010

House passes Senate's health care 'fixes' bill

Washington (CNN) -- The House of Representatives passed a slightly altered health care "fixes" bill Thursday night, completing legislative action on President Obama's top domestic priority.

The so-called "fixes" bill, approved by a 220-207 vote, now goes to Obama to be signed into law. It makes changes in the broader health care reform measure that Obama enacted Tuesday.

Approval by both the House and Senate on Thursday concluded a tortuous legislative struggle for the health care reform legislation, which received no Republican support in any of the major votes in either chamber dating back to last year.

"This is a very proud night in the history of this Congress," House Majority Leader Steny Hoyer told reporters, adding he expected Obama to sign the measure next week. Thursday's vote "completes the process of a bill that has been in the making literally for a century, and certainly for decades," said Hoyer, D-Maryland.

The "fixes" bill also included provisions to shift government funding for student loans away from commercial banks to new education initiatives. Until now, commercial banks have received federal subsidies for student loans.

Earlier Thursday, Senate Republicans forced two minor provisions involving the student loan funding to be stripped from the bill -- changes that required the House to take up the bill a second time but had no effect on the broader health care bill that took effect Tuesday.

A Senate Republican Budget Committee memo said the violations raised by GOP senators involved Pell grant spending that won't immediately affect the federal budget, and therefore was ineligible for inclusion in the measure. That's because the measure was being passed under reconciliation rules, which apply only to budget-related measures.

After the changes, the Senate approved the bill on a 56-43 vote to send it to the House a second time.

On Sunday, the House passed both the overall health care bill and the accompanying fixes bill as part of a complicated legislative process necessary to overcome unanimous Republican opposition.

Republicans used every parliamentary tool available to try to undermine both the overall health care bill and the fixes measure. They forced the Senate to begin deliberations on a series of proposed amendments starting Wednesday night. The Senate did not adjourn until 2:45 a.m. Thursday.

The Senate reconvened at 9:45 a.m. to consider additional GOP proposals which, among other things, were designed to force Democrats to cast unpopular votes in the run-up to November's midterm elections.

The Democrats' fixes bill was necessary to get a reluctant House to pass the Senate's health care reform measure unchanged. If there had been any changes to that initial bill, it would have had to go back to the Senate for another vote, which almost certainly would have failed. Since a special election earlier this year in which Democrats lost the Senate seat formerly held by Sen. Ted Kennedy, the party has not had enough votes to overcome a Republican filibuster.

That situation prompted the two-bill strategy Democrats are using. After passing the Senate bill without changes, House Democrats passed the fixes bill Sunday to alter provisions they did not like. Because the bill was being handled under the reconciliation rules in the Senate, only 51 votes were needed for passage.

The compromise package added more than $60 billion to the overall plan's cost partly by expanding insurance subsidies for middle- and lower-income families. Specific provisions included:

• Closing the Medicare prescription drug "doughnut hole" by 2020. Under current law, Medicare stops covering drug costs after a plan and beneficiary have spent more than $2,830 on prescription drugs. It starts paying again after an individual's out-of-pocket expenses exceed $4,550. Senior citizens stuck in the doughnut hole this year will receive a $250 rebate.

• Raising the threshold for imposing the so-called "Cadillac" tax on expensive health insurance plans to coverage valued at more than $10,200 for individuals and $27,500 for families. The tax won't kick in until 2018.

• Imposing an additional 3.8 percent Medicare payroll tax on investment income for individuals making more than $200,000 a year and couples making more than $250,000 a year.

• Eliminating a special exemption for the state of Nebraska from all new Medicaid expenses -- known as the "Cornhusker Kickback." The federal government will instead assist every state by picking up 100 percent of the costs of expanded Medicaid coverage between 2014 and 2016, and 90 percent starting in 2020.

• Reducing the fine for individuals who do not purchase coverage from $750 to $695.

• Increasing the fine on large companies failing to provide health coverage for workers from $750 to $2,000 per employee.

The compromise package would add more than $60 billion to the overall plan's cost partly by expanding insurance subsidies for middle- and lower-income families. It also would expand Medicare's prescription drug benefit while scaling back the bill's taxes on expensive insurance plans.

Among the GOP amendments to the fixes bill defeated by Democrats were a provision to eliminate new penalties being imposed on businesses whose workers use federally subsidized insurance.

In addition, Sen. Tom Coburn, R-Oklahoma, proposed that drugs for erectile dysfunction, such as Viagra and Cialis, be prohibited to sex offenders, and Sen. John McCain, R-Arizona, sought to strike so-called "sweetheart deals," such as an extra $300 million in Medicaid funds for Louisiana.

Republicans are "not serious about helping this bill," Senate Majority Leader Harry Reid, D-Nevada, said Wednesday. They are concerned only with "throwing roadblocks in front of anything we do."

Republicans raised points of order against the fixes bill on two provisions, and the Senate parliamentarian ruled them legitimate. Democrats lacked the 60 votes necessary to override the ruling.

CNN's Ted Barrett, Tom Cohen, Alan Silverleib, Lisa Desjardins and Deirdre Walsh contributed to this report.

Landmark health care overhaul bill heads to Obama's desk

Washington (CNN) -- A sweeping bill overhauling the U.S. medical system goes to President Obama's desk on Monday to be signed into law.

The House of Representatives passed the measure late Sunday, delivering a historic victory to Obama, who had made it his No. 1 domestic priority.

The bill passed in a 219-212 vote after more than a year of bitter partisan debate. All 178 Republicans opposed it, along with 34 Democrats.

The measure, which cleared the Senate in December, constitutes the biggest expansion of federal health care guarantees since Medicare and Medicaid were enacted more than four decades ago.

A separate compromise package of changes expanding the reach of the measure also passed the House over unanimous GOP opposition, and is now set to be taken up by the Senate.

The overall $940 billion plan is projected to extend insurance coverage to roughly 32 million additional Americans. It represents a significant step toward the goal of universal coverage sought by every Democratic president since Harry Truman.

Most Americans will now be required to have health insurance or pay a fine. Larger employers will be required to provide coverage or risk financial penalties. Total individual out-of-pocket expenses will be capped and insurers will be barred from denying coverage based on gender or pre-existing conditions.

The compromise package would add to the bill's total cost partly by expanding insurance subsidies for middle- and lower-income families. The measure would scale back the bill's taxes on expensive insurance plans.

Numerous House members insisted they would not vote for the Senate bill without a clear promise that senators would approve the changes.

"This is what change looks like," Obama said shortly after the votes. The passage of health care reform is "not a victory for any one party. ... It's a victory for the American people and it's a victory for common sense."

The president said successful reform proves Americans "are still a people capable of doing big things."

iReport: Share your views on health care reform

The rare Sunday votes occurred after a long weekend of intense negotiations among the White House, House leaders and individual Congress members. Obama traveled to Capitol Hill on Saturday to make a last minute plea to the House Democratic caucus. He spent much of the past week trying to personally persuade dozens of members.

House Speaker Nancy Pelosi, D-California, worked with administration officials to defuse a potential rebellion among socially conservative Democrats concerned that the bill wouldn't do enough to prevent taxpayer-funded abortions.

She also brokered a last-minute deal among several Democrats worried about disparities in Medicare funding for individual states.

Republicans failed to stop the Democratic health care initiative despite using virtually every weapon in their legislative arsenal. GOP leaders have repeatedly warned the plan will lead to a government takeover of America's private employer-based health care system.

They have also argued it will lead to higher premiums and taxes while imposing harsh Medicare cuts and doing little to control spiraling medical costs.

Pelosi and Boehner make final comments

Shortly before the House voted on the bill, Pelosi said health care reform was necessary to end insurance industry abuses and bring greater economic stability to most Americans.

Congress will be "making history, making progress and restoring the American dream" by passing reform, she said.

It's time to "complete the great unfinished business of our society." Health care "is a right and not a privilege."

House Minority Leader John Boehner, R-Ohio, argued that Democratic leaders had betrayed the trust of the public by pushing ahead with a bill that lacks broad public support.

"We have failed to listen to America and we have failed to reflect the will of our constituents," he said. "And when we fail to reflect that will, we fail ourselves and we fail our country."

He also slammed what he characterized as a legislative process marked by a lack of transparency and accountability.

"Look at how this bill was written," he said, his voice steadily rising. "Can you say it was done openly? With transparency and accountability? Without backroom deals? ... Hell no you can't!"

The $875 billion bill now headed to Obama's desk is projected to cut the federal deficit by $118 billion over the next 10 years, according to the nonpartisan Congressional Budget Office.

If the compromise plan clears the Senate, the bill's total cost will rise by $65 billion. Projected deficits, however, will be reduced by an additional $25 billion.

Key details of the bill

The plan, according to CBO projections, will cut budget deficits by more than $1 trillion in its second decade.

It will subsidize insurance for a family of four making up to about $88,000 annually, or 400 percent of the federal poverty level.

It also creates a series of health insurance exchanges designed to make it easier for small businesses, the self-employed and the unemployed to pool resources and purchase less expensive coverage.

Medicaid will be significantly expanded, ensuring coverage to those earning up to 133 percent of the poverty level, or just over $29,000 for a family of four.

The bill cuts projected Medicare spending by roughly $500 billion, in part through reductions in the Medicare Advantage program. Democratic leaders have promised the reductions will not affect service to Medicare recipients.

The bill hikes Medicare payroll taxes on families making more than $250,000.

Starting in 2013, it also imposes a 40 percent tax on insurance companies providing "Cadillac" health plans valued at more than $8,500 for individuals and $23,000 for families.

Proponents of the tax on high-end plans say it's one of the most effective ways to curb medical inflation. However, many Democrats oppose taxing such policies because it would hurt union members who traded higher salaries for more generous health benefits.

If the compromise bill becomes law, the threshold for imposing the Cadillac tax will be raised to health plans valued at more than $10,200 for individuals and $27,500 for families.

The tax won't kick in until 2018.

Buy insurance or pay a fine

Under the plan now headed to Obama, individuals are required to purchase health insurance coverage or face a fine of up to $750 or 2 percent of their income -- whichever is greater. It includes a hardship exemption for poorer Americans.

Companies with more than 50 employees that don't provide coverage are required to pay a fee of $750 per worker if any of its employees rely on government subsidies to purchase coverage.

The compromise package would drop the individual fine to $695 or 2.5 percent of income, whichever is greater. The fine on companies failing to provide coverage would jump to $2,000 per employee.

Federally funded abortion coverage for people purchasing insurance through the exchanges will be banned under the bill now passed by Congress. Exceptions will be made in cases of rape, incest, or danger to the life of the woman.

Individuals receiving federal assistance who want abortion coverage will have to purchase the coverage using private funds.

Illegal immigrants will be barred from buying insurance in the health insurance exchanges.

Parents, however, will be entitled to keep their children on their health care plans until age 26.

While passage of the Senate bill is a major win for Democrats on a major party priority, Pelosi had to take a number of steps in recent weeks to assuage House members unhappy with the measure.

A deeply unpopular special exemption for the state of Nebraska from all new Medicaid expenses -- known as the "Cornhusker kickback" -- would be eliminated under the compromise plan. The federal government will instead assist every state by picking up 100 percent of the costs of expanded Medicaid coverage between 2014 and 2016, and 90 percent starting in 2020.

The speaker also tried to sweeten the deal for some progressive members of her caucus partly by adding additional subsidies and a major student loan overhaul measure to the compromise plan.

The measure -- a priority for Obama -- would end the practice of having private banks offer student loans and would expand direct lending from the government.

Closing the "doughnut hole"

In addition, the compromise plan would close the Medicare prescription drug "doughnut hole" by 2020. Under current law, Medicare stops covering drug costs after a plan and beneficiary have spent more than $2,830 on prescription drugs. It starts paying again after an individual's out-of-pocket expenses exceed $4,550.

Senior citizens stuck in the doughnut hole this year would receive a $250 rebate.

Several fiscally conservative Democrats were assuaged by the Congressional Budget Office's estimate of the bill's long-term effect on the federal deficit.

A key group of anti-abortion Democrats, meanwhile, was reassured by a last-minute promise of an executive order from Obama stating that the provisions in the health care bill comply with the 32-year-old Hyde Amendment, which sharply restricts federal funding for abortion.

Emotions exploded shortly after the vote, however, as one Republican shouted "baby killer" at Michigan Rep. Bart Stupak, a leader of anti-abortion Democrats involved in negotiations over Obama's order.

The speaker also considered trying to help unhappy House Democrats by allowing them to avoid a direct vote on the Senate bill. Numerous Congress members had advocated passing a rule that would have deemed the Senate bill approved once the separate package of changes had passed.

GOP leaders objected furiously to the so-called deem and pass move. House leaders backed away from the idea on Saturday.

Republicans are still fuming over Democrats' decision to use a legislative procedure called reconciliation that will allow the compromise measures to clear the Senate with a simple majority of 51 votes.

Senate Democrats lost their filibuster-proof 60-seat supermajority in January with the election of GOP Sen. Scott Brown of Massachusetts.

Republicans say that reconciliation, which is limited to provisions pertaining to the budget, was not meant to pass a sweeping overhaul measure such as the health care bill. Democrats point out that reconciliation was used to pass several major bills in recent years, including George W. Bush's 2001 and 2003 tax cuts.

House Democrats have been continually reassured that the compromise package will be approved by the more conservative Senate.

Pelosi said Friday that "when our members go to vote, they will have all the assurances they need" that the Senate will approve the compromise plan.

Senate Majority Leader Harry Reid, D-Nevada, attended the Saturday meeting between Obama and House Democrats. He presented a letter indicating that the Senate would use reconciliation to pass the House's changes.

"We believe that health insurance reform cannot wait and must not be obstructed," the letter said. "We support an up-or-down majority vote and will vote to make these improvements."

The letter was not signed, though Reid told the House members that a majority of the Senate backs reconciliation.

Brown, however, decried the vote and said the nation can't afford the measure.

"Today's vote shows that leaders in Washington continue to ignore the will of the people," he said. "Americans have sent a message to Washington for the past year, including with my election, that they are opposed to this multitrillion-dollar health care bill that will raise taxes, increase premiums, cut Medicare and leave future generations with a mountain of debt."

CNN's Ted Barrett, Dana Bash, Craig Broffman, Tom Cohen, Lisa Desjardins, Evan Glass, Brianna Keilar, Deirdre Walsh and Robert Yoon contributed to this report.

THROWBACK THURSDAY: KEITH MURRAY- GET LIFTED

N.Y. State Police loses second chief in 2 weeks

New York (CNN) -- New York state's top police official announced Wednesday he was quitting, the second acting superintendent to step down in as many weeks.

In a letter to embattled Gov. David Paterson, Pedro Perez denied his resignation was connected to the ethics scandals embroiling Albany.

"My retirement is not premised on the current investigation by the Attorney General [Andrew Cuomo], as I know my decisions were honest and rightly motivated," Perez said in the letter, which the New York State Police released.

Perez's resignation takes effect Friday and ends his 28-year career as a police officer, his letter said.

His predecessor, Harry Corbitt, quit March 2, less than a week after the abrupt resignation of Denise O'Donnell as New York's deputy secretary for public safety. O'Donnell said Corbitt had misled her about state police involvement in a scandal involving a top aide to the governor.

The Democratic governor has been mired in controversy since news reports emerged alleging an aide was involved in a domestic violence incident with a woman and that state police later allegedly pressured the woman to keep quiet.

The aide, David Johnson, has been suspended without pay.

Corbitt has said he did not dispute O'Donnell's account of what he told her but said, "The conclusions she appeared to draw from these statements were incorrect."

Separately, the New York State Commission on Public Integrity on March 3 accused Paterson of an ethics violation for allegedly accepting free tickets to the first game of last year's World Series.

The commission also said Paterson lied under oath about intending to pay for the tickets.

Paterson's spokesman, Peter Kauffmann, resigned the next day, saying he could not keep doing his job "in good conscience."

The governor's office said it was reviewing the commission's findings.

"Gov. Paterson maintains his innocence and intends to challenge the findings of the commission both with respect to the law and the facts," the office said.

The governor could face up to an $80,000 fine for violating the state's gift ban for public officials, and up to $10,000 if he is found to have used his official position to secure unwarranted privileges.

The commission has asked Cuomo, the state's attorney general, and the Albany County district attorney to investigate.

Cuomo is a possible Democratic contender for the governor's office in 2010.

Paterson, a former New York lieutenant governor who stepped into the governor's mansion when Eliot Spitzer resigned in 2008 over a prostitution scandal, has abandoned his campaign for election to a full term, saying it was not the "latest distraction but an accumulation" of obstacles behind his decision.

WE MISS YOU B.I.G.

TRIBUTE TO THE NOTORIOUS B.I.G.

Today is the 13th anniversary of the death of one of the GREATEST MC's to bless the mic. The Notorious B.I.G. Today we celebrate his GREATNESS